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. 2014 Jun 24;9(6):e100225.
doi: 10.1371/journal.pone.0100225. eCollection 2014.

Validation of the surgical fear questionnaire in adult patients waiting for elective surgery

Maurice Theunissen  1 , Madelon L Peters  2 , Erik G W Schouten  2 , Audrey A A Fiddelers  1 , Mark G A Willemsen  1 , Patrícia R Pinto  3 , Hans-Fritz Gramke  1 , Marco A E Marcus  4
Affiliations

Validation of the surgical fear questionnaire in adult patients waiting for elective surgery

Maurice Theunissen et al. PLoS One. .

Erratum in

Abstract

Objectives: Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity and reliability of the SFQ.

Methods: Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis.

Results: EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity.

Discussion: The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.

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Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts: The department of Anesthesiology of the MUMC+ receives payments of Grünenthal for consultancy activities of M. Marcus. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

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Grants and funding

This study was conducted with departmental funding and supported by a grant from The Netherlands Organisation for Scientific Research (Zon-MW, http://www.zonmw.nl/en/), grant no. 110000007. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.